A relational and embodied approach to online EMDR therapy
People sometimes wonder whether effective trauma therapy is possible online, and that question makes a lot of sense. My answer is yes. When the circumstances support it, virtual EMDR can be deeply supportive.
I began studying EMDR when COVID started because I wanted a useful trauma therapy tool to offer my clients online. Over the past five years, I have been delighted and surprised by the meaningful shifts I have witnessed through virtual EMDR.
Virtual EMDR therapy brings the full EMDR process into a secure video session. The work unfolds while you remain in your own space, building the therapeutic relationship, strengthening resources, preparing for trauma work, and mapping ways to create positive change in your daily life.
EMDR stands for Eye Movement Desensitization and Reprocessing. It is an eight-phase treatment that works with the ways past experiences continue to shape thoughts, emotions, beliefs, body responses, and present-day patterns. Like any therapy, the process begins by building safety within the therapeutic relationship.
Virtual EMDR begins with relationship and preparation
Before we begin reprocessing traumatic material, we spend time getting to know one another and creating conditions in which the work can feel protected, nurtured, and able to blossom.
A sense of safety between us can grow through experiences of being heard, respected, and responded to with care. You may notice whether there is room to ask questions, name what you need, express uncertainty, slow the process down, and share when something feels off. This relationship becomes an important part of the foundation for EMDR treatment.
We also explore whether virtual therapy feels right for you, what brings you to therapy, the experiences that may be shaping your life now, and the resources already available to you. Resources might include supportive relationships, pets, embodied strengths, creativity, spiritual practices, connection with nature, meaningful places, community, and ways you have learned to care for yourself. Resources look different for every person, and we can discover together what supports you personally.
Preparation may include strengthening your ability to remain connected to the present, stabilizing areas of your life that need additional support, and developing ways to tend to difficult emotions or body sensations. We may build tools for feeling calm and grounded in daily life, become more familiar with the strategies that helped you survive, and practice the forms of bilateral stimulation we may use.
As a foundation of resources and stability grows, we begin treatment mapping. Together, we look at how present-day triggers, symptoms, painful beliefs, body responses, and relationship patterns may connect with earlier experiences. This helps us identify a focus for healing that feels clear and workable.
Preparation is part of EMDR. It may take a few sessions, several months, or a year. Each person arrives with a different history, relationship to safety, and access to support. Taking the time your system needs can create the conditions for trauma reprocessing to feel productive, connected, and sustainable.
What happens through the screen?
We meet over secure video while you remain in your own environment. We begin by arriving together and checking in. We may talk about what has been happening since our last session, reconnect with your treatment plan, or notice what feels most present that day.
During reprocessing, we bring a manageable part of an experience into awareness. This may include an image, memory, painful belief, emotion, or body sensation. We then begin bilateral stimulation, or BLS, in short sets.
Within EMDR, bilateral stimulation is used to support regulation, shifts in painful beliefs, and new insights or connections. As processing unfolds, the memory may begin to feel more fully located in the past, allowing it to settle into its place within the memory bank of your mind and body.
Between sets, I check in and invite you to notice what is emerging. You may become aware of thoughts, images, emotions, sensations, memories, impulses, or shifts in how you understand the experience. We follow the process with curiosity and make adjustments as needed.
How does bilateral stimulation work online?
Bilateral stimulation alternates attention from one side of the body or visual field to the other. In virtual EMDR therapy, this may include:
- Following guided eye movements across the screen
- Alternating taps on your shoulders, arms, or legs
- Listening to alternating sounds through headphones
- Using another form of bilateral stimulation chosen together, such as alternating tactile or creative movements
We can experiment with the method that feels right for you. Some people prefer eye movements, while others feel more connected through tapping, sound, or movement. Comfort, accessibility, and your response to the process help guide the choice.
The National Center for PTSD and the EMDR International Association describe eye movements, therapist-guided self-tapping, and alternating sounds as options for providing bilateral stimulation through telehealth.
Staying connected during virtual EMDR
I stay attentive to your words, facial expression, body, pace, breath, protective responses, and the shifts that happen between us. I also pay attention to my own embodied experience and what it may help me understand about the process.
There is room for pauses, questions, uncertainty, humor, emotion, and changes in direction. Consent remains active throughout the session. You can ask for a slower pace, a different form of bilateral stimulation, more information, or time to reconnect with the present. I will remind you of this throughout the process.
A pause can help us listen more closely to what your system is communicating.
We can pause and continue.
We can orient to the room, tend to a protective response, clarify what you need, and decide together what comes next.
Preparing your space for online EMDR
Your physical environment can become part of the support around the work. You may want to have:
- A private space where you feel comfortable
- A stable internet connection
- A computer or tablet with enough screen space for eye movements
- Wired or wireless stereo headphones for alternating sounds
- Water and tissues
- A blanket, pillow, or sensory support
- A pet, plant, meaningful object, or crystals or stones nearby
- Time after the session to transition into the rest of your day
We can also talk about which resources you would like within reach. Your space can help you feel connected, supported, and present.
What happens if the connection drops?
We will make a plan for technology interruptions before beginning reprocessing. This includes choosing a backup way to reconnect and identifying what you can do while the video connection returns. Planning ahead gives us a shared path for navigating a technology interruption together.
Is virtual EMDR therapy a good fit for you?
Virtual EMDR can offer meaningful flexibility and accessibility. Some people appreciate working from a familiar environment with their own comforts, sensory supports, pets, and meaningful objects nearby. Meeting online can also leave more time and energy for transitioning after a session.
Fit is personal. We consider your privacy, internet access, support system, current needs, and how it feels to engage through video. You deserve space to ask questions and experience the process before deciding what feels right. Together, we can explore whether virtual EMDR therapy offers the connection, structure, and support you need.
I offer virtual EMDR therapy and EMDR intensives for adults throughout California. A free 20-minute consultation gives us a chance to meet, talk about what you hope to work on, and explore whether working together feels like a good fit.
About the author: Erica Berman, LMFT is a queer trauma therapist, EMDR Certified Therapist, and EMDRIA Approved Consultant. Her work brings together relational, somatic, and trauma-focused approaches.